Survival Analysis And Early Screening Of Endometrial Cancer Patients

Background:Endometrial carcinoma is the most common gynecologic malignancy. We studied clinical data among 385 patients who were diagnosed as endometrial carcinoma by surgery retrospectively to analyze and discuss the prognostic factors of endometrial carcinoma, we screened out independent risk factors to help determine clinical treatment of the patients.Methods:All the clinical data of 385 cases of endometrial carcinoma, from January 2004 to June 2010, was analyzed. The Kaplan-Meier test and multivariate Proportional hazards regression model (Cox regression) were used for finding those risk factors related to the prognosis of endometrial carcinoma. All the clinical data was analyzed retrospectively. By the analysis we found 3 independent risk factors and researched them in detail to improve the prognostic accuracy to serve clinical management.Results:Among 385 patients diagnosed at Peking Union Medical College Hospital from January 2004 to June 2010, the overall 5-year survival rate reached 90.4%. The Kaplan-Meier test suggested that age, vaginal bleeding, menopause, FIGO surgical stage, histological grade, depth of myometrial invasion, pathological type, postoperative adjuvant therapy, lymph node metastasis and peritoneal cytology related to survival rate (P<0.05). Lymphatic dissemination reveals no statistical significance on the survival rate by clinical stage comparison in endometrial carcinoma (P>0.05). Adjuvant therapy in early stage patients had no significant impact on survival rate (P >0.05). Cox-proportional hazards regression model indicates FIGO surgical stage, pathological type and age are the independent risk factors (P<0.05, OR value were 2.146、2.233、2.596). Patients with non-endometrioid, advanced FIGO surgical stage and ages older than 60 years reveal poor survival rate.Conclusions:Age, vaginal bleeding, menopause, FIGO surgical stage, histological grade, depth of myometrial invasion, pathological type, postoperative adjuvant therapy, lymph node metastasis and peritoneal cytology are related to survival rate. Pathological type, FIGO surgical stage and age are the independent predictive factors for the prognosis of endometrial carcinoma. Definitive effect of the lymphadenectomy and peritoneal cytology in endometrial carcinoma is unclear.Objective:To compare diagnostic accuracy and adequacy of endometrial sampler through which we can acquire both cytological and histological specimens with dilatation and curettage. Method:From March 2015 to June 2015, 62 patients were diagnosed by endometrial sampler which had a special vacuum device to help gather cytological and histological specimens before D&C diagnosis in the Department of Obstetrics and Gynecology, Peking Union Medical College Hospital. Uterine cytological and acquisitions were categorized under five headings: unsatisfactory, normal, atypia, tumor cell suspicious and tumor cell. Histologic sections from endometrial sampler, together with cytology were compared with hysterectomy specimens from D&C. Chi-square, and T-test were used in the study. The sensitivity, specificity, diagnostic accuracy were calculated. Result:By cytology, sensitivity, specificity, diagnostic accuracy were 83.3%,93.9%,91.8% respectively between ES sampler and D&C, which can reach up to 84.6%,95.8%,93.4% respectively when the diagnose is associated with biopsy by the sampler. Conclusion:ES sampler and D&C showed almost equal accuracy rate in the diagnosis of endometrial pathologies. But ES sampler is a more economic and quick technique compared with D&C, and can be considered prior to D&C.